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Epidemiology of drug interactions in cancer patients

Nature Reviews Cancer volume 6, page 824 (2006)Cite this article

A Correspondence to this article was published on 01 October 2006

We thoroughly enjoyed reading the recent article by Scripture and Figg entitled “Drug interactions in cancer therapy”1. The authors did an extensive review of the literature on mechanisms of drug interactions, focusing on potential interactions between chemotherapeutic agents and other medications as well as food and herbal drugs. This is a neglected issue in clinical practice, and a comprehensive review on this topic is welcome. One aspect of this topic that was not covered in the review is the epidemiology of such interactions. There is very little in the literature on this particular aspect of drug interactions in oncology, but we have conducted two studies of potential drug interactions in cancer patients that can begin to give an insight into the magnitude of this problem.

The first study evaluated the frequency of potential drug interactions in 100 consecutive hospitalized cancer patients who were not receiving antineoplastic therapy2. In that study, 63% of patients were exposed to at least one potential drug interaction. Our second study evaluated the epidemiology of potential drug interactions among 405 ambulatory cancer patients who received standard cancer-directed therapy3. Using the highly accurate Drug Interactions Facts4 software, we screened for and classified drug interactions by level of severity (major, moderate or minor) and scientific evidence (1–5, with 1 representing the highest level of evidence)5. Among 405 patients, 276 potential drug interactions were identified in 27% of them. Most potential interactions involved non-anticancer agents (87%), were classified as either major or moderate (86%) and had good evidence in the literature (level ≤3: 52%). Most potential interactions related to anti-hypertensive agents, warfarin, aspirin and anticonvulsants.

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References

  1. Scripture, C. D. & Figg, W. D. Drug interactions in cancer therapy. Nature Rev. Cancer 6, 546–558 (2006).

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  2. Riechelmann, R. P., Moreira, F., Smaletz, O. & Saad, E. D. Potential for drug interactions in hospitalized cancer patients. Cancer Chemother. Pharmacol. 56, 286–290 (2005).

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  3. Riechelmann, R. P., Tannock, I. F., Wang, L. & Krzyzanowska, M. K. Drug interactions in ambulatory cancer patients receiving cancer-therapy. American Society of Clinical Oncology [online], (2006).

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  5. Wolters Kluwer . Drug Interaction Facts (software). Facts and comparisons [online], (1994).

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Authors and Affiliations

  1. Department of Medical Oncology and Hematology, Princess Margaret Hospital, 610 University Avenue, Toronto, M5G 2M9, Ontario, Canada

    Rachel P. Riechelmann & Monika K. Krzyzanowska

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  1. Rachel P. Riechelmann
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  2. Monika K. Krzyzanowska
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Correspondence to Rachel P. Riechelmann.

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Riechelmann, R., Krzyzanowska, M. Epidemiology of drug interactions in cancer patients. Nat Rev Cancer 6, 824 (2006). https://doi.org/10.1038/nrc1887-c1

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